Early predictors of quiescent asthma in late childhood

Mohammad Al Sallakh, Sarah Rodgers, Aziz Sheikh, Ronan Lyons, Gwyneth Davies

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Childhood asthma may become quiescent later in life. Identifying modifiable factors may allow early intervention to increase the likelihood of asthma quiescence.

Objectives: To identify early predictors of short-term quiescence of childhood asthma.

Methods: We used the Secure Anonymised Information Linkage Databank (SAIL) in Wales to retrospectively follow-up 7921 children with asthma diagnosed at age 5-10 between 2000-2014 who were treated in the 1st year of diagnosis. We used asthma GP prescriptions as a proxy for disease activity in each follow-up year. We defined short-term quiescence as a minimum of 5 consequent prescription-free years and tested its association with several covariates measured in the 1st year of diagnosis using a Cox proportional hazards model adjusted for age, sex and socioeconomic status.

Results: The cohort included 58.2% males, with mean age-at-diagnosis of 7.3 (SD 1.48) and 49,597 person-years of follow-up (mean 7.3; SD 3.8). Short-term asthma quiescence was less likely with history of eczema (HR 0.73, 0.61-0.88), being on BTS treatment step 3 or higher in the 1st year (0.77, 0.65-0.92), and asthma emergency admissions (0.29, 0.09-0.91) in that year; but it was more likely with history of respiratory infections (1.30, 1.12-1.51). No significant association was found with allergic rhinitis.

Conclusion: Milder disease (up to BTS Step 2), absence of asthma emergency admissions, and history of respiratory infection may increase the chances of at least short-term asthma quiescence in children. Future work will use longitudinal observation of additional factors with to predict the disease course.

Funding: Health and Care Research Wales, ABMU Health Board. Support: AUKCAR AUK-AC-2012-01.
Original languageEnglish
JournalEuropean Respiratory Journal
Volume48
Issue number60
Early online date8 Nov 2016
DOIs
Publication statusE-pub ahead of print - 8 Nov 2016

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